Innovation in Medical Devices

FISH on a chip: Cancer detection done faster, cheaper and better
New technology ready to be commercialized as real-time test

Overview: Dr. Linda Pilarski and her colleagues at the University of Alberta have developed a new technology for diagnosing cancer faster (hours instead of days) and more economically (tens of dollars instead of hundreds). Dr. Pilarski's team devised a microfluidic chip the size of a microscope slide that can perform fluorescent in situ hybridization (FISH) – a technique to detect mutations in chromosomes for a number of different types of cancers – on a handheld diagnostic device. Currently, FISH is a complex and expensive process, which means that it's infrequently used in clinical situations. Dr. Pilarski's FISH on a chip will allow widespread use of the test because of its significantly higher speed and lower costs.

Impact: The device has strong potential for widespread clinical use. The rapid detection of chromosomal mutations will increase a physician's ability to tailor treatment strategies to target individual cancers. The FISH on a chip technology could be commercialized as an automated, real-time test for the detection and monitoring of cancer and other medical conditions.

"By identifying abnormal chromosomes, a device like FISH on a chip facilitates customizing treatment for individual patients, tailored to better target their disease. It's one of those situations where the patient and the health-care system can benefit enormously – and at lower cost."

Overview: Low back pain is one of North America's most challenging and costly occupational health issues. Soft tissue injuries in the Ontario workforce account for almost two-thirds of all lost-time claims – 40% of which are for back injuries. To address this growing problem, a team led by Dr. Joan Stevenson at Queen's University in Kingston is developing the Personal Lift Assistive Device (PLAD). Invented byDr. Mohammad Abdoli, a former PhD student in Dr. Stevenson's lab and current Professor at Ryerson University, PLAD is an "external force generator." It attaches at the shoulders, pelvis and feet and has elastic elements that ease the load during lifting and forward bending.

Impact: Working with the Queen's team, Ove Industrial Design of Toronto developed a self-contained suit for PLAD that has been tested in auto assembly plants. The use of PLAD should reduce the risk of injuries among workers who are constantly bending and lifting. It may also be helpful in rehabilitating workers who suffer from low back pain and injuries, helping them to return to their jobs. Prevention of such a common injury should help reduce lost work time and ease the strain on the health-care system.

"What industry really wants is something that will reduce time lost to injuries. It works very well and should be quite useful to lots of people."

Dr. Joan Stevenson Queen's University

Sound bites: Finding the right fit for children's hearing aids
Technology already being used by hearing aid manufacturer

Overview: Each year, more than 400 Canadian children are born with impaired hearing and many need hearing aids. Conventional hearing aids often have a limited ability to help children to hear low-volume, high-pitched sounds. This can make it more difficult for them to understand words or say certain sounds. In a project jointly funded by CIHR and the Natural Sciences and Engineering Research Council, Dr. Susan Scollie of the University of Western Ontario tested a new hearing aid technology that works by lowering the pitch of high frequency sounds and developed a method to optimize this benefit for young children. The three-year project pooled the expertise of audiologists, engineers, psychologists and speech-language pathologists.

Impact: The fitting method that Dr. Scollie's team developed and tested in the project has been paired with a commercial version of the hearing aid, and is now available through audiology clinics around the world. Several other research centres in the world have now taken up the commercialized technology and are beginning to use it in research.

"Any clinic in the world now can purchase a device that offers the signal programmer we tested. The software uses our lab's procedures for setting the individual control parameters for a child. It's immensely satisfying to see it go forward to a clinical product."

Dr. Susan Scollie University of Western Ontario

Innovation in Aging Research

If the shoe fits: Keeping seniors on their feet and out of the surgery ward
Innovative shoe insole restores seniors' sense of balance

Overview: Fear of falling often keeps older people from stepping out into the world to get fresh air and exercise. No wonder: according to Health Canada, one-third of Canadian seniors fall each year, with hip fractures the most common fall injury. About 20% of injury-related deaths among seniors can be traced back to a fall. To deal with this growing problem in an aging society, Dr. Stephen Perry of Wilfrid Laurier University developed Sole SensorTM, a shoe insert with a built-in ridge along the outside that improves the foot's sensory perception and prevents falls. Dr. Perry came up with the idea for the device while he was a CIHR-funded PhD student at the University of Toronto. He developed it with help from his supervisor Dr. Brian Maki and Drs. William McIlroy and Geoff Fernie.

Impact: Sole SensorTM has important implications for improving quality of life for seniors – who will be able to walk more confidently, get more exercise and maintain health. The potential cost savings to the health-care system are considerable if the device can reduce stress on emergency rooms, surgery wards and orthopedic clinics. The patented technology has been licensed to Ontario-based Hart Mobility, who are manufacturing and marketing the inserts.

"Older people fear falling, so they stay in. They don't exercise, so they lose functionality. It's a cycle of decline. Giving them more confidence – so they can go out more often – might be just enough to get them to boost up their strength."

Dr. Stephen PerryWilfrid Laurier University

Innovation in Neuroscience

Make it stop: Investigations aim to ease the suffering of chronic pain
Researchers commercializing discoveries with new life sciences company

Overview: Between 20% and 30% of Canadians experience chronic pain – pain that lasts for more than six months – at some point in their lives. Currently, chronic pain is mainly treated with morphine derivatives, which have questionable efficacy and several side-effects, including potential dependency problems. Dr. Yves De Koninck of Laval University has helped demonstrate that chronic pain is not a symptom but a disease in itself. His team has identified an ion pump dysfunction in the nervous system that amplifies the transmission of pain signals. Based on this discovery, he is developing a new class of painkillers – neurotherapeutics that act by modulating chloride in the central nervous system – designed to be more effective in providing relief from chronic pain without the side-effects and problems associated with morphine derivatives.

Impact: A CIHR Proof of Principle grant helped Dr. De Koninck and his research associates found Chlorion Pharma, a Quebec-based biopharmaceutical company focused on neurotherapeutics. The company is led by Dr. Jeffrey Coull, a former member of Dr. De Koninck's lab, who has developed a compound for pain relief and is preparing to test it in clinical trials.

"What I've shown is that dysfunction of the nervous system can be the source of pain, not the primary disease. It's very important to have people recognize that chronic pain is a disease in itself – because then you have the obligation of treating it. It's a major unmet need."

Dr. Yves De KoninckLaval University

Fatal reaction: Children's genetic responses to abuse linked to suicide
Canadians are world leaders in significant new research field

Overview:McGill University's Drs. Michael Meaney and Moshe Szyf are leaders in the burgeoning field of epigenetics, which explains how environment and experience affect our genes. For instance, epigenetic factors such as methylation patterns that control gene expression may act as the mediators of communication between the environment and the genome. A CIHR-funded project – Environmental stressors and epigeneticeffects in major depression and suicide – examined the methylation patterns of genes in subjects who were abused during childhood and died by suicide. Drs. Meaney and Szyf, in collaboration with McGill colleague Dr. Gustavo Turecki, found that early life events can alter the epigenetic status of the genes that mediate brain function and contribute to a higher risk of suicide.

Impact: Epigenetics represents an entirely new way of looking at, diagnosing and treating human disease. The transposition of animal data to human studies suggests that certain compounds have been shown to affect epigenetic changes and counteract negative nurturing influences in humans. This work holds promise for new approaches to pharmacology for difficult-to-treat mental disorders. It also has potential application for treating other diseases, such as cancer – an epigenetic disease in which the DNA methylation pattern is defective, leading to the production of tumours – and Alzheimer's disease.

"We know that the same process is involved in many different diseases, but each disease has its own story that, hopefully, we will be able to target with a specific drug. Epigenetics opens up tremendous possibilities."

Overview: Alzheimer's disease affects 300,000 Canadians, gradually stealing cognitive ability and memory before causing death. One in three people over 85 has the disease or a related dementia. Abnormal deposits of the protein amyloid are believed to be involved in the pathology of the disease. Fragments, called Abeta 42, break off into toxic clusters that become plaque and interfere with the brain cells' ability to communicate with each other. Dr. JoAnne McLaurin of the University of Toronto's Centre for Researchin Neurodegenerative Diseases has developed a drug called AZD-103/ELND005 that latches onto the Abeta 42 fragments to help flush them from the brain before plaque forms.

Impact: After multiple Phase I Clinical Trials showed that AZD-103/ELND005 was well tolerated by humans, the U.S. Food and Drug Agency fast-tracked the drug for an 18-month Phase II clinical trial, with results expected in 2010. Transition Therapeutics, a Canadian biopharmaceutical company, has entered a worldwide agreement with the Elan Corporation for the joint development and commercialization of AZD-103/ELND005. This new Alzheimer's treatment – which patients can take in the form of a tablet – has tremendous life-improving, life-saving and commercial potential.

"I'm drawn to fixing something that's wrong. The question was, what does this peptide bind to that makes the neuron die? We hypothesized that its nearest binding partners would be the lipids within the cell membrane. So we characterized what lipids it liked and the characteristics of the various families it bound to and came up with a common structure. And that led to this drug."

Dr. JoAnne McLaurinUniversity of Toronto

Innovation in Regenerative Medicine

Overview: Knee replacements represent a major health-care cost, and the wait for surgery can last years. Dr. Caroline Hoemann at École Polytechnique de Montréal and her colleagues Dr. Georges-Étienne Rivard at the Sainte-Justine Hospital in Montreal and Dr. Hani El-Gabalawy at the University of Manitoba have come up with creative approaches to boost the wound repair response to biodegradable gel implants that contain a polymer called chitosan. The implant coaxes the knee joint to repair itself by drawing stem cells to the damaged area that can then develop into healthy cartilage cells.

Impact: Because the implant is injected and solidified in the knee defect in a simple, outpatient-based surgery, use of the gel could save millions of dollars in health-care costs while keeping people physically active well into their senior years. The procedure was previously co-developed by Dr. Hoemann through other collaborations involving BioSyntech, a Quebec-based medical device company. The implant is already approved for clinical testing, and multi-centre randomized trials are now in progress across Canada and in Europe. BioSyntech is marketing the BST-CarGel® implant as its platform technology for repairing damaged cartilage, while avoiding invasive surgery.

"What we're aiming at is to develop new ways to enhance the vascular response in the bone below the cartilage lesion, so we can treat older patients and extend the options of treatment for cartilage repair to people in their 60s and even in their 70s."

Dr. Caroline HoemannÉcole Polytechnique de Montréal

Innovation in Water Research

Clean water: Tracking water contaminants to their source protects health
Many British Columbia communities use new assessment tool

Overview: Water is essential to Canada's economic prosperity. Safe drinking water is essential to the health of its population. Deaths and outbreaks of illness in recent years due to contaminated drinking water have greatly heightened Canadians' concerns. Dr. Asit Mazumder, an NSERC Industry Research Chair at the University of Victoria, led a four-year CIHR-funded collaborative study to track the sources of coliform bacteria contamination in several watersheds in the Okanagan and on Vancouver Island in British Columbia. To ensure knowledge transfer, Dr. Mazumder's research team partnered directly with federal and provincial government departments, livestock industries and municipalities.

Impact: As a result of the study, Dr. Mazumder's lab developed a unique risk assessment tool for measuring potential health risks to water supplies from fecal (human, livestock and wildlife) contamination of source water. The approach combines the use of molecular (DNA) markers with biochemical and geochemical markers of septic and sewage origins. Through co-operation with Dr. Mazumder's lab, the tool is now in use in Victoria, Kamloops, Vernon, Prince Rupert, and Kelowna. His lab works with federal and community partners to characterize and model the safety of ground water in First Nations communities across Canada.

"On every project, I start with the question: 'Who is going to use it?' That's the basic focus. Transferring the work to the end-users is what it's all about."

Dr. Asit MazumderUniversity of Victoria

Innovation in Information and Communications Technologies

Lots of MOXXI: A prescription for the medical office of the future
New technology spells closing time for toxic drug cocktails

Overview:McGill University's Dr. Robyn Tamblyn has developed a unique computerized drug management system and is testing the latest iteration with doctors and pharmacists in Quebec City and Montreal. MOXXI (Medical Office of the 21st Century) helps doctors to see a patient's medication and hospitalization records, electronically prescribe a new medication or stop an old medication. Physicians can check for potentially harmful drug interactions or allergies before deciding how to treat a patient. The work represents a major advance in information and communications technology in health care.

Impact: MOXXI will give physicians information that is otherwise difficult to obtain, allowing them to manage their patients better. Computerization will reduce medication errors and lessen the volume of adverse drug reactions. It will also give patients greater control over their medical information and treatment, as they will be able to access their medical records, request prescription refills, schedule appointments, and have e-consultations with their doctors through online portals. The CIHR-funded Dr. Tamblyn and her colleagues also have created a new web version to enable more secure access by patients and physicians, regardless of their location. MOXXI NG (Next Generation) was released in 2008 and 60,000 patients are participating in the testing of the system.

"We've begun moving into emergency rooms. We're giving people in the emergency departments information about what drugs people are on. That's a huge time-saver, and it resolves the issue of not knowing what people were taking and inadvertently not prescribing what was needed – especially during admission."

Dr. Robyn TamblynMcGill University

Innovation in Arctic Research

Overview: Canada's Aboriginal Peoples have unique health and nutritional challenges. This is particularly true in the Far North, where the traditional reliance on foods that are hunted, fished and collected locally has given way to dependence on high-fat, high-sugar convenience items flown or shipped in from the South. In response to a request from the Tetlit Gwich'in of Fort McPherson, Northwest Territories for help in addressing concerns over the changing dietary patterns and the increasing burden of chronic disease, McGill University's Dr. Harriet Kuhnlein undertook a two-year, CIHR-funded study to provide evidence for policy development to protect traditional food resources for their health-promoting properties, and to improve purchasing patterns in food stores. On a broader scale, these challenges are also being investigated by CIHR-supported researcher Dr. Grace Egeland of McGill, leader of the International Polar Year and Inuit Health Study.

Impact: Dr. Kuhnlein's study resulted in the launch of a community-driven, 18-month health promotion project emphasizing availability and access to traditional Gwich'in food and good quality market food. It spawned the publication of a community-edited book on Gwich'in food and health and led to the production of an independently funded documentary video about the concerns of the Tetlit Gwich'in for their traditional foods, and their efforts to improve nutrition and prevent chronic disease in Fort McPherson.

"People in the community are more aware of the impact that good food has on health. Positive change is most effective when community leaders are in the driver's seat."